Assessment of patient dose in digital systems

The assessment of patient dose has gained increased attention, still being an issue of concern that arises from the use of digital systems. The development of digital technology offers the possibility for a reduction of radiation dose around 50% without loss in image quality when compared to a conventional screen–film system. Digital systems give an equivalent or superior diagnostic performance and also several other advantages, but the risk of overexposure with no adverse effect on image quality could be present. This chapter refers to the management of patient dose and provides an explanation of dose-related concepts. In this chapter, exposure influence in dose and image representation and the effects of radiation exposure are also discussed.

Microstrip antenna array for multiband dedicated short range communications systems

Dedicated Short Range Communications (DSRC) is the key enabling technology for the present and future vehicular communication for various applications, such as safety improvement and traffic jam mitigation. This paper describes the development of a microstrip antenna array for the roadside equipment of a DSRC system, whose characteristics are according with the vehicular communications standards. The proposed antenna, with circular polarization, has a wide bandwidth, enough to cover the current European DSRC 5.8 GHz band and the future 5.9 GHz band for next generation DSRC communications. (C) 2011 Wiley Periodicals, Inc. Microwave Opt Technol Lett 53: 2794-2796, 2011; View this article online at wileyonlinelibrary.com. DOI 10.1002/mop.26394

Semiconductor Device as Optical Demultiplexer for Short Range Optical Communications

In this paper we present results on the use of a multilayered a-SiC:H heterostructure as a wavelength-division demultiplexing device for the visible light spectrum. The proposed device is composed of two stacked p-i-n photodiodes with intrinsic absorber regions adjusted to short and long wavelength absorption and carrier collection. An optoelectronic characterisation of the device was performed in the visible spectrum. Demonstration of the device functionality for WDM applications was done with three different input channels covering the long, the medium and the short wavelengths in the visible range. The recovery of the input channels is explained using the photocurrent spectral dependence on the applied voltage. An electrical model of the WDM device is proposed and supported by the solution of the respective circuit equations. Short range optical communications constitute the major application field, however other applications are also foreseen.

Evaluation of pharmaceutical assistance in public primary care in Brasília, Brazil

OBJECTIVE: Pharmaceutical assistance is essential in health care and a right of citizens according to Brazilian law and drug policies. The study purpose was to evaluate aspects of pharmaceutical assistance in public primary health care. METHODS: A cross-sectional study using WHO drug indicators was carried out in Brasília in 2001. From a random sample of 15 out of 62 centers thirty exiting patients per center were interviewed. RESULTS: Only 18.7% of the patients fully understood the prescription, 56.3% could read it, 61.2% of the prescribed drugs were actually dispensed, and mean duration of pharmaceutical dispensing was 53.2 seconds. Each visit lasted on average 9.4 minutes. Of prescribed and non-dispensed drugs, 85.3% and 60.6% were on the local essential drug list (EDL) respectively. On average 83.2% of 40 essential drugs were in stock, and only two centers had a pharmacist in charge of the pharmacy. The mean number of drugs per prescription was 2.3, 85.3% of prescribed drugs were on the EDL, 73.2% were prescribed using the generic denomination, 26.4% included antibiotics and 7.5% were injectables. The most prescribed groups were: cardiovascular drugs (26.8%), anti-infective drugs (13.1%), analgesics (8.9%), anti-asthmatic drugs (5.8%), anti-diabetic drugs (5.3%), psychoactive drugs (3.7%), and combination drugs (2.7%). CONCLUSIONS: Essential drugs were only moderately available almost 30 years after the first Brazilian EDL was formulated. While physician use of essential drugs and generic names was fairly high, efficiency was impaired by the poor quality of pharmaceutical care, resulting in very low patient understanding and insufficient guarantee of supply, particularly for chronic diseases.

Optimization, high availability and redundancy in information communications and technology using networks and systems virtualization architectures

Mestrado em Engenharia Informática

Low Profile Multi-Band Antenna for Mobile Communications

In this paper, the design of low profile antennas by using Electromagnetic Band Gap (EBG) structures is introduced. Taking advantage of the fact that they can behave as Perfect Magnetic Conductor (PMC), it is shown that these structures exhibit dual band in-phase reflection at WLAN (Wireless Local Area Network) bands, the 2.4 GHz and 5.2 GHz bands. These structures are applied to PIFA (Planar Inverted-F Antenna) and the results show that it is possible to obtain low profile PIFA's.

Assessment of nursing students and nurses' orientation towards patient-centeredness

Background - Being patient centered is a core value for nursing. Patient centered-care has been related to patient and health provider satisfaction, better health outcomes, higher quality of care and more efficient health care delivery. Objectives - The purpose was to assess the orientation adopted by nurses and students in patient care, using The Patient-Practitioner Orientation Scale, as well as to compare the results between resident nurses and students from different academic years. Settings - Public School of Nursing and a Central Hospital, in Lisbon (Portugal). Participants - Students in the first, second and fourth year of nursing school and nurses participated in the study. Methods - For data collection, we used The Patient-Practitioner Orientation Scale (European Portuguese version), an instrument designed to measure individual preferences toward the dimension of caring a sharing in health professional-patient relationship. Students and nurses also filled out two additional questions about their perception of competence in technical and communication skills. Additional demographic information was also collected, including gender, age, academic year and length of professional experience. Results - A total of 525 students (84.7% female) and 108 nurses (77.8% female) participated in this study. In general, caring sub-scores, measuring the preference of about attending to patient emotional aspects, were higher than sharing sub-scores, measuring beliefs about giving information and perceiving patient as a member of the health team. Students were significantly more patient-centered throughout their nursing education (p<0.001). Comparing to students in the second and fourth academic years (p<0.001) nurses' scores were significantly lower both in total PPOS and in caring and sharing subscales. Conclusions - These results reinforce the idea that patient centeredness may be developed in academic context. The scores obtained highlight the importance of studies that aim to identify factors that may explain the decrease of patient centeredness in professional practice.

Interface HL7 para observation patterns

Com a generalização das tecnologias de informação e comunicação na área da saúde, a monitorização remota de pacientes, a partir de dispositivos móveis, é uma realidade que contribui para uma melhor qualidade de vida dos pacientes. Mas, não são só os pacientes que ganham com a introdução destas tecnologias, também os profissionais de saúde e os hospitais retiram as suas vantagens. Os profissionais de saúde são munidos de uma ferramenta móvel de monitorização permanente de sinais vitais, aumentando desta forma a ligação médico-paciente. Relativamente aos hospitais, estes vêem os custos de manutenção reduzirem, em virtude da possibilidade dos pacientes puderem ser monitorizados a partir dos seus lares. Neste projecto pretende-se identificar mecanismos que possibilitem responder de forma eficaz à necessidade de partilha de informação, nomeadamente protocolos de comunicação, segurança e sistemas de integração. Foi projectado um protótipo, constituído por um middleware e uma aplicação cliente móvel, onde o middleware tem como missão garantir a interoperabilidade entre um servidor HL7 e a aplicação cliente, utilizada pelo profissional de saúde. A normalização da informação médica trocada entre o servidor HL7 e o middleware obedece à norma internacional HL7.

The hospital survey on patient safety culture in Portuguese hospitals: instrument validity and reliability

Purpose – Quantitative instruments to assess patient safety culture have been developed recently and a few review articles have been published. Measuring safety culture enables healthcare managers and staff to improve safety behaviours and outcomes for patients and staff. The study aims to determine the AHRQ Hospital Survey on Patient Safety Culture (HSPSC) Portuguese version's validity and reliability. Design/methodology/approach – A missing-value analysis and item analysis was performed to identify problematic items. Reliability analysis, inter-item correlations and inter-scale correlations were done to check internal consistency, composite scores. Inter-correlations were examined to assess construct validity. A confirmatory factor analysis was performed to investigate the observed data's fit to the dimensional structure proposed in the AHRQ HSPSC Portuguese version. To analyse differences between hospitals concerning composites scores, an ANOVA analysis and multiple comparisons were done. Findings – Eight of 12 dimensions had Cronbach's alphas higher than 0.7. The instrument as a whole achieved a high Cronbach's alpha (0.91). Inter-correlations showed that there is no dimension with redundant items, however dimension 10 increased its internal consistency when one item is removed. Originality/value – This study is the first to evaluate an American patient safety culture survey using Portuguese data. The survey has satisfactory reliability and construct validity.

Integração da tecnologia Near Field Communications nas telecomunicações móveis

O telemóvel tem-se transformado numa ferramenta essencial no nosso dia-a-dia, constantemente são lançadas novas tecnologias que potenciam o uso do telemóvel nas tarefas do nosso quotidiano. Atualmente a grande tendência passa por fazer o download de aplicações com o objetivo de obter mais e diferentes tipos de informação, existe o desejo de ler de forma simples e intuitiva o mundo que nos rodeia, como se cada elemento fosse um objeto sobre o qual conseguiremos obter informação através do telemóvel. A tecnologia Near Field Communication (NFC) ajuda a transformar este desejo ou necessidade numa realidade de simples alcance. Podemos anexar “identificadores” nos objetos e “ver” estes identificadores através do telemóvel recorrendo a aplicações que fazem a ponte com os sistemas que nos permitem obter mais informação, por exemplo, internet. O NFC especifica um padrão de comunicação de redes sem fios, que permite a transferência de dados entre dois dispositivos separados por uma distância máxima de 10cm. NFC foi desenhado para ser integrado em telemóveis, que podem comunicar com outros telemóveis equipados com NFC ou ler informação de cartões ou tags. A dissertação avalia as oportunidades que a tecnologia NFC oferece ao mundo das telecomunicações móveis, nomeadamente na realidade do operador Vodafone Portugal, principalmente numa relação Empresa - Cliente. Esta tecnologia reúne o interesse dos fabricantes dos telemóveis, dos operadores e de parceiros críticos que vão ajudar a potenciar o negócio, nomeadamente entidades bancárias e interbancárias. A tecnologia NFC permite utilizar o telemóvel como um cartão de crédito/debito, ticketing, ler informação de posters (Smart Poster) que despoletem navegação contextualizada para outras aplicações ou para a internet para obter mais informação ou concretizar compras, estes são alguns cenários identificados que mais valor o NFC consegue oferecer. A dissertação foca-se na avaliação técnica do NFC na área de Smart Posters e resulta na identificação num conjunto de novos cenários de utilização, que são especificados e complementados com o desenvolvimento de um protótipo.

Níveis de referência em diagnóstico em tomografia computorizada para planeamento em radioterapia

Mestrado em Radiações Aplicadas às Tecnologias da Saúde- Ramo de especialização: Terapia com Radiações

Real-time communications over hybrid wired/wireless PROFIBUS-based networks

PROFIBUS is an international standard (IEC 61158) for factory-floor communications, with some hundreds of thousands of world-wide installations. However, it does not include any wireless capabilities. In this paper we propose a hybrid wired/wireless PROFIBUS solution where most of the design options are made in order to guarantee the proper real-time behaviour of the overall network. We address the timing unpredictability problems placed by the co-existence of heterogeneous transmission media in the same network. Moreover, we propose a novel solution to provide inter-cell mobility to PROFIBUS wireless nodes.

A checklist for patient safety rounds at the care pathway level

Objective - To define a checklist that can be used to assess the performance of a department and evaluate the implementation of quality management (QM) activities across departments or pathways in acute care hospitals. Design - We developed and tested a checklist for the assessment of QM activities at department level in a cross-sectional study using on-site visits by trained external auditors. Setting and Participants - A sample of 292 hospital departments of 74 acute care hospitals across seven European countries. In every hospital, four departments for the conditions: acute myocardial infarction (AMI), stroke, hip fracture and deliveries participated. Main outcome measures - Four measures of QM activities were evaluated at care pathway level focusing on specialized expertise and responsibility (SER), evidence-based organization of pathways (EBOP), patient safety strategies and clinical review (CR). Results - Participating departments attained mean values on the various scales between 1.2 and 3.7. The theoretical range was 0-4. Three of the four QM measures are identical for the four conditions, whereas one scale (EBOP) has condition-specific items. Correlations showed that every factor was related, but also distinct, and added to the overall picture of QM at pathway level. Conclusion - The newly developed checklist can be used across various types of departments and pathways in acute care hospitals like AMI, deliveries, stroke and hip fracture. The anticipated users of the checklist are internal (e.g. peers within the hospital and hospital executive board) and external auditors (e.g. healthcare inspectorate, professional or patient organizations).

Real-time fieldbus communications using Profibus networks

This paper provides a comprehensive study on how to use Profibus fieldbus networks to support real-time industrial communications, that is, on how to ensure the transmission of real-time messages within a maximum bound time. Profibus is base on a simplified timed token (TT) protocol, which is a well-proved solution for real-time communication systems. However, Profibus differs with respect to the TT protocol, thus preventing the application of the usual TT protocol real-time analysis. In fact, real-time solutions for networks based on the TT protocol rely on the possibility of allocating specific bandwidth for the real-time traffic. This means that a minimum amount of time is always available, at each token visit, to transmit real-time messages, transversely, with the Profibus protocol, in the worst case, only one real-time message is processed per token visit. The authors propose two approaches to guarantee the real-time behavior of the Profibus protocol: (1) an unconstrained low-priority traffic profile; and (2) a constrained low-priority traffic profile. The proposed analysis shows that the first profile is a suitable approach for more responsive systems (tighter deadlines), while the second allows for increased nonreal-time traffic throughput

Scheduling real-time communications with P-NET

In this paper we address the P-NET Medium Access Control (MAC) ability to schedule traffic according to its real-time requirements, in order to support real-time distributed applications. We provide a schedulability analysis based on the P-NET standard, and propose mechanisms to overcome priority inversion problems resulting from the use of FIFO outgoing buffers